Is VA Vocational Rehabilitation About To Improve? VA To Add Nearly 20 Percent New Counselors

The Department of Veterans Affairs finally increased the headcount of its little known VA Vocational Rehabilitation program by hiring 20 percent more counselors.

“The VR&E program is much more than a benefits program,” said VA Secretary Robert Wilkie. “It’s a vital support network, where VA’s expert counselors work closely with Veterans on their personalized vocational rehabilitation goals. Congressional funding enables us to expand our team of counselors who are on the ground across the country working tirelessly for Veterans, and we appreciate their support.”

After years of complaints from veterans and their Voc Rehab Counselors, the agency decided to augment its agency staff rather than rely solely on software solutions to improve efficiencies. Presently, the agency serves around 180,000 veterans, which is quite a bit higher than the number claimed in the VA press release.

This increase is the first significant boost in hiring counselors for many years.

Background

For some background, the Vocational Rehabilitation program’s stated purposes are “to provide to eligible veterans with compensable service-connected disabilities all services and assistance necessary to enable them to achieve maximum independence in daily living and, to the maximum extent feasible, to become employable and to obtain and maintain suitable employment.”

Pre-2014, it was not abnormal for qualified veterans to secure approval for retraining programs including advanced degrees including doctorates or terminal masters degrees. I received sponsorship to become an attorney as did retired Senator Jim Webb and many others. The program covered self-employment programs and helped veterans find jobs.

Liberalizing movements within the agency after 2009 were aimed at increasing access to programs, and I was one of those veterans.

Since 2014, the caseload increased substantially from around 120,000, but the program’s funding and staff sizes remained static. The agency’s workaround was to pay $12 million for a custom client management software solution to increase efficiencies without substantively increasing funding or the number of counselors. After four years, the agency’s IT department completely failed to create a functional system leaving veterans in the lurch.

To offset problems resulting from stagnant funding and understaffing, the agency focused on tightening its awards to veterans. Demand for vocational benefits increased substantially but funding and human capital did not increase.

Adding to the pressure was a 2015 performance standard that implemented tighter quotas. How do you put a quota on counseling veterans given the significant differences between veterans and their cases?

And, in 2016, the agency allowed its Voc Rehab Counselors to be usurped into AFGE union as bargaining unit employees, which forced counselors to work within the typical 40 hour work week rather than working as long and as hard as the job required. Employees needing to work longer hours on harder cases then had a disincentive over-commit time to difficult cases resulting in rubber stamp denials.

Present Day

Now, the agency reportedly requires additional levels of approval from Central Office that dissuade approvals by counselors in the field. Counselors who work too many hours to catch up on difficult cases are frequently penalized for working too hard if you can believe it.

It is akin to the settlement restriction David Shulkin implemented last year. Regional office leadership previously had the ability to settle wrongful termination cases without much oversight. Shulkin put an end to that by implementing a $5000 limit whereby leadership would need to seek permission before offering to settle cases.

As a result of the hurdle, the regional offices nationwide no longer settle cases even when the due process errors are obvious.

To meet their performance quotas, overworked counselors lack the ability to commit time to outlier cases that require additional approvals. So, veterans get wrongly denied or pushed into training paths of least resistance rather than what the veteran wants. Worse yet, some counselors outright lie to veterans about their veterans to push them out of the program more quickly.

ABOUT FOUNDER
Benjamin Krause is a lawyer, investigative reporter and award-winning veterans advocate. He is author of the guide Voc Rehab Survival Guide for Veterans and chief editor of DisabledVeterans.org.
He received his Bachelors from Northwestern University and Law Degree from the University of Minnesota, both using VA Vocational Rehabilitation and Employment.
He is also featured regularly in national publications as an authority on Department of Veterans Affairs policy such as Bloomberg News, Foreign Policy Magazine, Washington Times, Fox News, CBS, NBC, Star Tribune and more.
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Check this out from yesterday on “military.com”
Titled:
“VA Secretary Says Department Has New Mission: Customer Service”

From: “Military.com’
Dated: 29 Aug 2018
By “Richard Sisk”

“Department of Veterans Affairs Secretary Robert Wilkie pledged Wednesday to usher in a new era of “customer service” at the government’s second-largest bureaucracy that will give veterans the care they’ve earned without having to resort to a “cauldron of lawyers.”

“In an address to the 100th national convention of the two-million-member American Legion, Wilkie also said he has the commitment of Defense Secretary Jim Mattis to work together on developing a new electronic “patient-centered health care system” to allow for smooth transitions from active-duty to veteran status.”

“To stress the point on electronic records, Wilkie, an Air Force Reserve colonel who was sworn into office July 30, referred, as he frequently does, to the experience of his late father, retired Army Lt. Col. Robert Leon Wilkie Sr., who was severely wounded in the U.S. operation in Cambodia in 1970.”

“His father was 6-foot-2 and 240 pounds before he was wounded, Wilkie said, and came home weighing 115 pounds. For treatment at the VA, the second-largest government department after the Pentagon, his father had to carry around 800 pages of medical records to ensure care, he added.”

“Wilkie, the former assistant secretary of defense for personnel and readiness at the Pentagon, said he received a final order from Mattis, a retired Marine general, when he left the Pentagon to go to the VA: “From here on out, the Defense Department and the VA will be joined at the hip” on electronic records.”

“In his 21-minute address to the Legion in Minneapolis, Wilkie said the VA provides excellent care. The problem is “just getting our veterans through the door to get that care.”

“The VA is about serving veterans. Our responsibility is to serve you well and honorably. My prime directive is customer service,” he said, and it should not be up to the veteran “to employ a cauldron of lawyers to get the VA to say ‘Yes.’ It’s up to the VA to say ‘Yes’ to them. That is where the VA must go.”

“In that effort, “I pledge to you that this is a bottom-up organization, that the Legion has a seat at the table, that you have an open door to the 10th floor,” where his office is located at VA headquarters, he added.”

“Wilkie said customer service should improve under the VA Mission Act, which was signed into law by President Donald Trump in June and is aimed at giving veterans improved access to private-sector care when it is in their best interests.”

“He said increased funding under the act should alleviate many of the problems associated with the previous Choice Program, although Congress has yet to appropriate funding. The Mission Act is projected to cost more than $50 billion over five years.”

“Wilkie also repeated assurances he made at his Senate confirmation hearing that improved access to private care is not a smokescreen for the “privatization” of the VA health care system at more than 1,200 facilities nationwide.”

“Veterans need care from providers who can speak “in the language of veterans” and who “know what you’ve been through,” he said, adding that that is “not an option that the private sector can provide.”

“The private sector also “cannot replicate” what the VA does on spinal cord and traumatic brain injuries, prosthetics, services for the blind, and suicide prevention, Wilkie said.”

“His electronic health records (EHR) pledge has been met with skepticism in the House, where a new oversight subcommittee has been set up to check on the $10 billion-plus contract he signed as acting VA secretary with Cerner Corp of Kansas City, Missouri.”

“The VA is undertaking the largest transition to EHR ever attempted in the U.S., requiring oversight from the new Subcommittee on Technology Modernization, Rep. Phil Roe, R-Tennessee, chairman of the House Veterans Affairs Committee, said in a statement last month.”

“As the department embarks on the nation’s largest overhaul, it is critical that we ensure veterans and taxpayers are protected throughout the transition,” he said in a statement Thursday.”

“Roe, a physician, said, “I have personally gone through a transition to a new health record system when I was in private practice, and I know how much potential there is for a project like this to be a costly disruption. Congress has a duty to conduct rigorous oversight every step of the way.”

“He named Rep. Jim Banks, R-Indiana, a former Navy Reserve supply officer and Afghanistan veteran, to head the new subcommittee.”

“Service members and veterans deserve a seamless, lifetime medical record and an electronic health record system that supports the highest quality care,” Banks said. “However, I have no illusions about the challenge confronting VA in this monumental undertaking.”

“At the beginning of his remarks, Wilkie paid tribute to the passing of Sen. John McCain, R-Arizona, who died Aug. 25 after a year-long battle against glioblastoma, a terminal form of brain cancer.”

“A few days ago, we lost one of America’s great warriors, a man whose lifetime of selfless service reminds all of us why we do what we do. I want to thank the American Legion for honoring Sen. John McCain,” he said.”

“Wilkie made no mention of the action of Denise Rohan, the Legion’s national commander, in joining with AMVETS in charging that Trump had failed to show “proper respect” for McCain by having the rooftop flag of the White House returned to full staff Monday morning.”
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End of bullshit!

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Here’s the comment section!

Joseph OBrien15 hours ago Very skeptical! Recently I got a letter from the VA informing me that due to a major fire at the records repository in ‘73 the possibly exist that my medical records might not be available….I didn’t retire until ‘77 ?? Soooo the VA included a form with a request that I list any medical treatment I received when I was in the Military…..as I said I retired in ‘77 over 40 years ago and my Military service goes back 60 years and I’m supposed to remember when I was treated in the Military……I can see where this is going….sorry we have no record of any Military treatment !

34121579Joseph OBrien1 hour ago Unfortuanately that’s most likely the response the VA got from the National Archives when they requested your Service Medical Records. Recommend you submit SF-180 directly to the National Archives for a copy.

Lorence Parker17 hours ago Good Luck on trying to get any Introverted Government Employee to display Customer Service. If it ain’t in the Script they won’t do it. Going above and beyond is a not what the Union Steward will say to Management. When the 40 hours are up the GS employee is out the door.

The VA fills vacancies in the next budget year, which runs from October 1st to September 30th. The budget for the upcoming fiscal year for each VA Regional Office is approved by June of the existing year.

If the VRE counselor positions are accounted for by June 2019, then the positions can be hired for and filled starting October 2019. The VA hiring process can take six months or more. However, if the money is not “fenced” specifically for this purpose, then it can be allocated for other areas also within the time frame.

I will keep my fingers crossed, however it is still an uphill battle at this point

Where Secretary Wilkie and his mission are concerned, I am an audience member hoping for a good show, that ultimately results in ALL veterans getting the accurate medical diagnosis they require in order to obtain the proper medical care and all benefits earned.

It is also our duty to keep those coming through the gates behind us, informed of things we’ve learned on our journey through the system, hoping to clear a smoother path for them. “…Wilkie also said he has the commitment of Defense Secretary Jim Mattis to work together on developing a new electronic “patient-centered health care system” to allow for smooth transitions from active-duty to veteran status.”” This seems to me as good a place as any to start an improvement. If it becomes a smoother transition project than many of us dealt with, well how can I say we shouldn’t give it a try.

To be clear, I am not at all wanting to be the cheerleader for the VistA/Cerner/EHR project, but for transitioning veterans, where Cerner and DOD are already fully engaged, I say go for it and best of luck.

@ Thomas Evans,
Thank you for posting info on an expected timeline, that should clear up some questions.

Off Topic
This just in.
“https://abcnews.go.com/Politics/wireStory/trump-cancels-pay-raise-due-federal-workers-january-57504058?cid=clicksource_4380645_2_three_posts_card_hed”

“President Donald Trump is canceling pay raises due in January for most civilian federal employees, he informed Congress on Thursday, citing budget constraints. But the workers still could see a slightly smaller boost in their pay under a proposal lawmakers are considering.
Trump said he was nixing a 2.1 percent across-the-board raise for most workers as well as separate locality pay increases averaging 25.7 percent.

“We must maintain efforts to put our Nation on a fiscally sustainable course, and Federal agency budgets cannot sustain such increases,” said Trump. The president last year signed a package of tax cuts that is forecast to add about $1.5 trillion to federal deficits over 10 years.
Trump cited the “significant” cost of employing federal workers as justification for denying the pay increases, and called for federal worker pay to be based on performance and structured toward recruiting, retaining and rewarding “high-performing Federal employees and those with critical skill sets.”

His announcement came as the country heads into the Labor Day holiday weekend.
Democrats immediately criticized the move, citing the tax cuts Trump signed into law last December. That law provided steep tax cuts for corporations and the wealthiest Americans, and more modest reductions for middle- and low-income individuals and families.
“Trump has delivered yet another slap in the face to American workers,” said Democratic National Committee Chairman Tom Perez.

Under the law, the 2.1 percent raise takes effect automatically unless the president and Congress act to change it. Congress is currently debating a proposal for a slightly lower, 1.9 percent across-the-board raise to be included in a funding bill that would require Trump’s signature to keep most government functions operating past September.
Unions representing the 2 million-member federal workforce urged Congress to pass the 1.9 percent pay raise.

“President Trump’s plan to freeze wages for these patriotic workers next year ignores the fact that they are worse off today financially than they were at the start of the decade,” said J. David Cox Sr., president of the American Federation of Government Employees, which represents some 700,000 federal workers.

“They have already endured years of little to no increases and their paychecks cannot stretch any further as education, health care costs, gas and other goods continue to get more expensive,” added Tim Reardon, national president of the National Treasury Employees Union.
Cox said federal worker pay and benefits have been cut by more than $200 billion since 2011.
Congress has approved legislation to give military service members a 2.6 percent pay raise, the biggest in nine years, but funding for the pay raise has not yet been approved.

In July, the Trump administration sharply revised upward its deficit estimates compared to the estimates in the budget proposal it sent Congress in February. The worsening deficit reflects the impact of the $1.5 trillion, 10-year tax cut, as well as increased spending for the military and domestic programs that Congress approved earlier this year.
T
he administration’s July budget update projected a deficit of $890 million for the fiscal year that ends Sept. 30, up from the February estimate of $873 billion. The $890 billion projection represents a 34 percent increase from the $666 billion in 2017.
For 2019, the administration is projecting the deficit will top $1 trillion and stay above that level for the next three years.
The only other period when the federal government ran deficits above $1 trillion was the four years from 2009 through 2012, when the government used tax cuts and increased spending to combat the 2008 fiscal crisis and the worst economic downturn since the 1930s.
Rep. Gerry Connolly, D-Va., who represents many federal workers, blamed what he said was Trump’s mismanagement of federal government.
“His tax bill exploded the deficit, and now he is trying to balance the budget on the backs of federal workers,” Connolly said.
AP Economics Writer Martin Crutsinger and Associated Press writers Matthew Daly and Zeke Miller contributed to this report.”

“Following the hearing, we asked if VA officials weren’t using the Academy report selectively now — ignoring it as a justification to add ailments to the Agent Orange presumptive list but citing it to try to block benefits to more veterans with children born with spina bifida. The department challenged that view.

“Citing a specific scientific report to discuss pending legislation (HR 299) is nothing other than a reasonable and relevant way to address specific legislative provisions under consideration,” said Curt Cashour, VA press secretary.

“The issue of additional Agent Orange presumptive conditions is completely separate from HR 299, and the notion that the two issues must always be discussed together is contrary to what VA and the Senate committee were specifically examining at the Aug. 1 hearing,” Cashour added.”

“In March 2016, the Department of Veterans Affairs received the latest in a series of scientific literature reviews from the National Academy of Medicine on Agent Orange-associated ailments.

This one raised the possibility that VA might add as many as four new conditions — bladder cancer, hypothyroidism, Parkinson-like tremors and perhaps even hypertension — to its list of 14 illnesses it presumes have been caused by exposure to herbicides the U.S. military sprayed during the Vietnam War.

The report delivered in 2016 moved bladder cancer and hypothyroidism from “inadequate or insufficient” evidence of association to herbicide exposure up to the “limited or suggestive” evidence of association. That’s the same level VA previously relied upon to award Agent Orange benefits for conditions including laryngeal cancer, prostate cancer and cancers of the lung, bronchus or trachea.

Hypertension (high blood pressure), the report said, remained in the “limited or suggestive evidence” category too, where it was placed in a previous study. That’s the same evidence level used to add ischemic heart disease to the Agent Orange presumptive disease list for near automatic award of benefits.

The Academy also clarified that Vietnam veterans with “Parkinson-like symptoms,” but without a formal diagnosis of Parkinson disease, should be considered eligible for presumption of exposure to Agent Orange, just as Parkinson’s disease previously was connected to service in Vietnam.

At the same time, the birth defect spina bifida in the offspring of Vietnam veterans was demoted by the Academy since its last report, from the “limited or suggestive” association category down to “inadequate or insufficient.”

The Academy, previously called the Institute of Medicine, delivered this last report, Veterans and Agent Orange: Update 2014, after a panel of scientific experts spent two years reviewing the latest medical literature on health effects of dioxin and other harmful compounds in herbicides associated with certain diseases.

VA officials promised to review the results and that then-VA Secretary Bob McDonald would act on the Academy report’s findings by July 2016. With this report, however, the secretary faced no timeline for reaching a decision. That’s because Congress had allowed a statutory 180-day deadline governing secretarial actions on Agent Orange scientific reviews to expire in 2015.

The consequence has been that the Obama administration in its final year did nothing more than study the report. The same has been true with the Trump administration during its first 19 months. While Vietnam veterans with, for example, bladder cancer await a decision on whether they will gain VA health care and compensation, VA has been silent on the 2016 Academy findings.

That changed slightly on Aug. 1.

During a hearing of the Senate Veterans Affairs Committee dominated by discussion of the House-passed Blue Water Navy Vietnam Veterans Act (HR 299), VA Under Secretary for Benefits Paul R. Lawrence and VA’s chief consultant on post-deployment health, Dr. Ralph Erickson, referred to the latest Academy report on Agent Orange. They did so not to propose that a disease be added to VA’s list of conditions presumed caused by Agent Orange. Instead, they cited the report to urge senators to reject a House amendment to HR 299 that would extend Agent Orange benefits to certain Vietnam-era veterans who served in Thailand and had children born with spina bifida.

In his written testimony, Lawrence said VA “is concerned there is continued scientific uncertainty surrounding the association of spina bifida and exposure to Agent Orange. As found in the last relevant [Academy] report, an association between spina bifida and exposure to Agent Orange is no longer shown.”

Erickson reinforced the point with Sen. John Boozman (R-Ark.), after the senator said he was glad to see the House bill included a bill he had co-sponsored to provide Agent Orange benefits “to any child of a veteran with covered service in Thailand who is affected by spina bifida.” If the Senate passed an identical bill, said Boozman, children of Thailand-service veterans would get “the same health care, monetary allowance and vocational training” given children of Vietnam veterans with spina bifida.

“Are you all for or against that provision,” Boozman asked.

Erickson noted that the Academy in 2016 “actually downgraded the evidence for there being an association of spina bifida and the children of Vietnam veterans. That doesn’t mean VA withdrew that benefit. However, at the present time, extending the benefit further is a little tricky because the scientific foundation per the National Academy of Medicine has diminished remarkably.”

Following the hearing, we asked if VA officials weren’t using the Academy report selectively now — ignoring it as a justification to add ailments to the Agent Orange presumptive list but citing it to try to block benefits to more veterans with children born with spina bifida. The department challenged that view.”

What happens now that veterans can file class-action suits against VA?
By: Leo Shane III, Military Times, August 30th, 2018

“WASHINGTON — A recent federal court ruling allowing class-action suits against the Department of Veterans Affairs could lead to a host of new legal options for veterans who share similar illnesses, service records or bureaucratic headaches.

“It is a watershed moment,” said Greg Rinckey, a founding partner of the the law firm Tully Rinckey PLLC, which specializes in military law. “For veterans dealing with Gulf War illness or Agent Orange claims … this makes it easier for them to fight against big government.”

On Aug. 23, an eight-judge panel on the U.S. Court of Veterans Appeals ruled that in “appropriate cases,” class-action lawsuits against VA will be allowed. In the ruling, Chief Judge Robert Davis wrote that he hopes the decision will “shape our jurisprudence for years to come and … bring about positive change for our nation’s veterans.”

Previous court rulings had questioned long-standing precedent prohibiting such group lawsuits, even as other class-action filings have been brought against other federal entities. Rinckey said the move makes it possible for a group of veterans with similar grievances to use their numbers to put pressure on VA, and win legal relief.”

“For an individual vet, this doesn’t change anything,” he said. “But it opens a whole new type of cases that can be brought against VA, and how those veterans complaints can be answered.”

The irony of the appeals court ruling is that the case which allowed class-action lawsuits to move forward — Monk v. Wilkie — denied the plaintiff’s claim that his case should proceed as one. The panel ruled his desire to group together all veterans facing a wait of more than a year for appeals claims did not meet previously established standards for forming a class.

Catherine McCarthy, a student at the Veterans Legal Services Clinic at Yale Law School who handled the Monk lawsuit, said officials there are still considering whether to refile the case with new parameters.

But she said the ruling provides a roadmap for a host of other legal complaints. In several other clinic cases, plaintiffs have already eyed class-action suits for veterans who were exposed to toxic chemicals while serving, and for veterans whose benefits cases are stuck in bureaucratic processing.

“It’s still trial and error at this point to see what will work,” she said. “But it’s a great opportunity, because so much of what we hear wrong about VA are systemic problems, not just one veteran dealing with a single issue.”

“veterans now eligible for Space-A travel”
Air Force Wounded Warrior Program / Published August 30, 2018

“The 2019 National Defense Authorization Act was recently signed, which included a measure that will allow fully-disabled veterans the ability to utilize Space-Available travel. Travelers should contact their local Passenger Terminal for further details and review travel information found on the AMC Travel Page for specific details on the Space A travel program.”

“You’re already rated at 100%, what more do you want? I mean how much more of a handout do you think you deserve?”

These are the verbatim words my vocrehab counselor said to me when I submitted my application for assistance to help me remain in the workforce and find value in my life.

This is how we’re treated… like we’re suckling the bosom of welfare by asking for the benefits our service and injuries have earned us. This kind of betrayal is humiliating to veterans who have never turned away from a daunting task.

Now I’ve had to endure over six months without a single physical therapy or counseling appointment when I had weekly appointments for both for years. They refuse to schedule me in advance for my weekly appointments and say that I need to assertively plead for an appointment on a walk in basis when I need treatment. Sorry… I’ll die before I beg anyone to care about me. Especially when its painstakingly clear that they have no interest in preserving my life or improving the quality there of.

I am not seeking sympathy or anything. I am just putting my situation out there to show that NOTHING is changing or getting better at the VA for veterans in need of help.